Discovery Health: celiac disease

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Celiac Disease (Nontropical Sprue) What Is It? Symptoms What Your Doctor Looks fFor Prevention Treatment Prognosis What Is It? Celiac disease is a reaction by certain immune system cells (called T-lymphocytes) to gluten, a protein that is found in many grains, especially wheat, rye, barley and oats. Normally, these cells are designed to protect the body against invaders; but in celiac disease, the body mistakenly perceives gluten as the enemy and attacks it. In the process, the lining of the small intestine becomes inflamed and inefficient in absorbing nutrients. Although the exact causes are not known, celiac disease seems to have a genetic component: Susceptibility seems to be inherited, and this disease is particularly common in people of western Irish descent, affecting an estimated one in 300. Half of all individuals with celiac disease are diagnosed during childhood, as early as eight months of age. In adults, the disease is most commonly diagnosed between the 20s and 50s. Symptoms In children: Diarrhea Weight loss Failure to thrive. (grow normally) In adults: Chronic, foul-smelling diarrhea, which does not respond to nonspecific treatment with antidiarrheals Flatulence Weight loss Chronic fatigue You also may develop problems associated with fat-soluable vitamin deficiency: Scaling skin (also called hyperkeratosis, a result of Vitamin A deficiency); bruising (a result of Vitamin K deficiency); blood in the urine (also from lack of Vitamin K); numbness and tingling (from lack of Vitamin D and calcium); muscle spasms and/or bone pain (also from Vitamin D and calcium deficiency). What Your Doctor Looks For Characteristic "blunting" or flattening of the villi (which normally resemble fingers) lining the small intestine, as seen microscopically in biopsies taken during endoscopy. The presence of numerous inflammatory cells, detected by a biopsy, underneath where the villi used to be. Prevention Because some people inherit a genetic susceptibility to celiac disease, familiarize yourself with your family medical history and tell your doctor if anyone else in your family has experienced trouble eating grains, particularly, wheat, rye, barley and oats. If there is a family history of celiac disease or if you are a woman of Western Irish descent, breastfeeding your babies and postponing the introduction of foods with gluten may offer some protection to your children. If you are diagnosed with celiac disease, gluten must be totally excluded from your diet. Because gluten is a hidden component of many prepared foods — canned soups, peanut butter, tomato, mustard, chip and dip mixes, lunch meats, candy bars, yogurt, and hot dogs, to name just a few — you will need to become a diligent checker of ingredients on every food item you buy. If you are not certain whether a food contains gluten, try restricting your diet, testing foods one by one to see which disagree with you. You also may find it worthwhile to enlist a dietitian's help in developing a gluten-free diet. Treatment The goal is simple — removing gluten from the diet — but this can be a difficult task, because gluten is a frequent ingredient of prepared foods (see above). Your doctor can advise you on ways to achieve a gluten-free diet; also, specialized, gluten-free cookbooks can provide tremendous practical help. Once your diet is gluten-free, your symptoms should improve within a few weeks. If there is significant inflammation in the intestinal lining, your doctor may also prescribe a short course of corticosteroids. Note: For unknown reasons, even if gluten is successfully removed from the diet, a few people with celiac disease develop a small bowel cancer or lymphoma. Prognosis Celiac disease sometimes goes into spontaneous remission in children around age 5, causing only occasional symptoms. In others, strict adherence to a gluten-free diet can lead to healing of the small intestine. Last updated June 28, 2000 Used with the permission of the copyright owner. All rights reserved. Printer-friendly format Home | Register | Change Profile | Privacy Policy | Editorial Policy | Advertising Policy ©1999-2000 Discovery.com, Inc. All rights reserved. Portions of this site Copyright © 1996-2000 InteliHealth Inc. "InteliHealth" is a registered trademark of InteliHealth Inc. By using this service, you accept the terms of our Visitor Agreement. Please read it. The material on DiscoveryHealth.com is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen.